遊戲式身體活動對靜態平衡能力與注意力之影響：一對具妥瑞症狀之泛自閉症雙胞胎國中生個案研究

Effect of Game-Based Physical Activities on Static Balance and Selective Attention--A Case Study of Junior High School Twins with Autism and Tourette Syndrome

本研究依據Gentile提出的運動技能分類法，由易到難，設計出適合自閉症學生的遊戲式身體活動，以探討遊戲式身體活動對國中自閉症學生之靜態平衡能力及注意力之影響。研究對象為一對七年級具妥瑞症狀之泛自閉症國中生雙胞胎。在遊戲式身體活動介入前進行平衡能力測量與田字注意力測驗。遊戲式身體活動進行連續八週，一週兩次，一次45分鐘，每次活動結束後，進行靜態平衡能力的測量；注意力評估部分，於每週第二次活動結束後，進行田字注意力測驗。八週活動介入後，分別在第九週及第十週進行保留期的靜態平衡能力測量與注意力測驗。最後，以座標軸散布圖方式呈現時間遞移過程中其靜態平衡能力及注意力之動力變化。本研究有以下發現：一、兩名個案靜態平衡能力的進步軌跡都有進步，但差異頗大，且弟弟的進步幅度優於哥哥。二、個案哥哥的選擇性注意力有提升的趨勢，弟弟則為退步的趨勢。上述研究結果顯示：一、遊戲式身體活動訓練後能提升國中具妥瑞症狀之泛自閉症學生在張眼及閉眼單足站立之靜態平衡能力，且具有良好的介入及維持效果。二、遊戲式身體活動訓練後在提升國中具妥瑞症狀之泛自閉症學生選擇性注意力上成效不一致，對妥瑞症狀發作頻率較低者（個案哥哥）的選擇性注意力有所提升，但對妥瑞症狀發作頻率較高者（個案弟弟）的選擇性注意力則無明顯改善，甚至有倒退趨勢。 Purpose: On the basis of the motor skill taxonomy proposed by Gentile, the researchers designed easy-to-difficult game-based physical activities, which are suitable for students with autism and Tourette syndrome. The study investigated the effects of the gamebased physical activities (GPA) on static balance abilities and selective attention in junior high school twins with autism and Tourette syndrome. Methods: The participants were seventh-grade twins with autism and Tourette syndrome. Static balance tests and the Tien-Character Attention Test were empirically applied before the intervention that involved the game-based physical activities. The GPA lasted for eight weeks, twice per week, once for 45 minutes. The static balance was measured after each GPA course, whereas the Tien-Character Attention Test was applied once per week. The 8-weeks changes of the balance and attention were dynamically presented in the coordinate systems. Results/Findings: Through the 8-week intervention involving game-based physical activities, we obtained the following findings: 1) for both twins, the trajectories of improvement in static balance abilities showed very different trends, with the younger brother outperforming the older brother; and 2) the selective attention ability (inferred from the Tien-Character Attention Test scores) of the older brother improved, whereas that of the younger brother degenerated. Conclusions/Implications: The conclusions drawn in this study are outlined as follows: 1) After the intervention involving the game-based physical activities, the static balance abilities of the junior high school twins with autism and Tourette syndrome improved in the acquisition phase as well as the retention phase. 2) The selective attention of the twins with autism and Tourette syndrome was inconsistent. The older brother showed a higher frequency of tics in Tourette than the younger brother did. The younger brother showed more improvement in selective attention abilities from the game-based physical activities than the older brother did. A relatively high frequency of tics in Tourette seemed to engender no improvement in selective attention abilities, and a high frequency of tics may degenerate selective attention abilities.